Our experience in the diagnostics and therapy of patients with solitary peripheral lung tumours

Patients presenting with a solitary pulmonary nodule are often a serious diagnostic-therapeutic problem. The AIM of the present report is to share our experience with VATS in the diagnostics and therapy of patients with solitary pulmonary nodules.

Between 2005 and 2009 we performed primary videothoracoscopic tumor resection in 125 patients with peripheral lung tumours.

In 93 (74.4%) of the cases complete successful thoracoscopic resection of the tumor and subsequent intraoperative frozen section histology was accomplished. In the remaining 32 cases (25.6%) various reasons demanded conversion to thoracotomie with wedge resection of the nodule. 54.2% of the removed tumours were malignant and 45.8% - benign. In 18 of the patients the intraoperative frozen section histology diagnosis was primary bronchial carcinoma which required to do oncologic resection of the tumor. In 10 patients the intraoperative frozen section histology was unable to differentiate between pulmonary metastasis and primary bronchial carcinoma, and the oncologic resection was performed in another surgical session after the definitive pathomorphologic diagnosis had been available. In 28 of the cases pulmonary metastases of a primary extrapulmonary tumor were removed.

Despite improvement in the diagnostic techniques, only the video-thoracoscopic removal of the lung nodule and its subsequent histological examination enables the definitive diagnosis, solving definitively the problem with benign lesions and indicating appropriate treatment of the malignant pulmonary lesions.